Titre :

Protective sta-mca bypass to prevent brain ischemia during high-flow bypass surgery: case series of 10 patients

Auteur(s) :

Aboukais, Rabih [Auteur]
Verbraeken, Barbara [Auteur]
Leclerc, Xavier [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U1171
Gautier, Corinne [Auteur]
Vermandel, Maximilien [Auteur]
Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189
Bricout, Nicolas [Auteur]
Lejeune, Jean-Paul [Auteur]
Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189
Menovsky, Tomas [Auteur]

Titre de la revue :

Acta neurochirurgica

Nom court de la revue :

Acta Neurochir (Wien)

Date de publication :

2019-05-01

ISSN :

0942-0940

Mot(s)-clé(s) en anglais :

Ischemia
High-flow
Protective bypass
Sta-mca anastomosis
Aneurysm

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

BACKGROUND: High-flow extracranial-intracranial bypass is associated with a significant risk of ischemic stroke. The goal of this study is to evaluate the effectiveness of STA-MCA bypass preceding a high-flow bypass as a ...
Lire la suite >BACKGROUND: High-flow extracranial-intracranial bypass is associated with a significant risk of ischemic stroke. The goal of this study is to evaluate the effectiveness of STA-MCA bypass preceding a high-flow bypass as a means of protecting the brain from ischemia during the high-flow bypass anastomosis in patients with otherwise untreatable aneurysms. METHODS: This prospective study included 10 consecutive patients treated for complex/giant aneurysm using a previous combined STA-MCA bypass and high-flow EC-IC bypass between June 2016 and January 2018 when classical endovascular or microsurgical exclusion was estimated too risky. Early cranial Doppler, MRI, CT scan, and conventional angiography were performed in each patient to confirm patency of bypasses, measure flow in the anastomoses, detect any ischemic lesions, and evaluate exclusion of the aneurysm. RESULTS: The mean age at treatment was 55 years (range 34 to 67). The mean time of microsurgical procedure was 11 h (range 9 to 12). In all patients, the high-flow bypass was patent intraoperatively and complete occlusion of aneurysm was obtained. No ischemic lesions were noted on early MRI. One patient died from a large hemispheric infarction related to a common carotid artery dissection 10 days after the microsurgical procedure and immediate postoperative epidural hematoma was noted in one other patient. CONCLUSIONS: In this study, we described the use of a protective STA-MCA bypass, performed prior to the high-flow bypass, in order to reduce the risk of perioperative ischemic lesions without increasing the morbidity of the surgical procedure. This treatment paradigm was feasible in all ten patients without complications related to the STA-MCA anastomosis.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

CHU Lille
CNRS
Inserm
Université de Lille

Collections :

• Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189
• Troubles cognitifs dégénératifs et vasculaires - U1171

Date de dépôt :

2019-11-27T13:34:15Z